This paper aims to evaluate the F.A.S.T. stroke social marketing campaign in Aotearoa New Zealand using a culturally responsive approach, examining how whanau (extended family) decision-making processes influence campaign effectiveness for Māori and Pacific communities.
A mixed-methods approach featuring a redesigned culturally responsive survey instrument was developed using He Awa Whiria (the braided rivers approach), integrating Māori and Western knowledge systems. The self-selection survey was completed by 1,859 respondents, including 441 Māori and 161 Pacific peoples.
The evaluation revealed that 32.7% of respondents used collective approaches to health decision-making. Māori (7.7%) and Pacific (5.3%) participants were significantly less likely than non-Māori non-Pacific respondents (12.1%) to report making decisions individually. While 87.5% of respondents understood the critical action of calling emergency services for suspected stroke, disparities persisted in campaign awareness, with non-Māori/non-Pacific respondents 1.6 times more likely to have unprompted recall of the campaign. Nevertheless, Pacific respondents demonstrated particularly positive emotional responses to campaign materials, with 49.1% feeling that they “yes definitely” feel more prepared to recognise stroke after viewing materials.
Social marketing campaigns and evaluations in Aotearoa New Zealand should focus on whānau rather than individuals alone, recognising distributed health literacy and collective decision-making within family systems. Campaign delivery strategies require refinement to ensure equitable reach across population groups, with particular attention to the “Take Action” component of the F.A.S.T. message, which showed poor recall across all groups.
The whānau-centred evaluation approach challenges individualistic social marketing models and demonstrates how culturally responsive methods can generate more accurate insights into campaign effectiveness within Indigenous contexts.
This paper offers methodological innovations for more culturally responsive survey instrument design and conceptual contributions regarding collective health decision-making. By centring whānau and Indigenous perspectives, it presents a decolonising approach to social marketing research with relevance beyond Aotearoa New Zealand.
